The nurse is caring for a client who suffers from frequent blood clots and is currently taking argatroban. Which of the following conditions in the client's medical history would require them to take argatroban?
Heparin induced thrombocytopenia.
Ventricular Dysfunction
Myocardial infarction
Hepatotoxicity
The Correct Answer is A
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.
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Correct Answer is A
Explanation
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.
Correct Answer is D
Explanation
A) "Increase your potassium intake by eating more bananas and apricots.": Doxazosin is not a potassium-sparing medication, and there is no specific indication for increased potassium intake with this drug. This advice may be misleading, especially since excessive
potassium can pose risks, particularly in certain populations.
B) "Weigh yourself daily, and report any weight loss to your prescriber.": Daily weighing can be important for monitoring fluid retention in some conditions, but weight loss is not a common side effect of doxazosin. Instead, clients should be more concerned about weight gain due to fluid retention or potential side effects from the medication.
C) "The impaired taste associated with this medication usually goes away in 2 to 3 weeks.": Impaired taste is not a well-documented side effect of doxazosin. While some medications may cause changes in taste, this statement is not relevant for doxazosin and does not address the most critical aspects of its administration.
D) "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy.": This statement is accurate and important. Doxazosin can cause first-dose hypotension, leading to dizziness or fainting. Advising the client to lie down after the first dose helps mitigate the risk of hypotensive effects, making this the most appropriate emphasis for the nurse.